<fieldset class="layui-elem-field">
    <legend>直系亲属信息</legend>
    <div class="layui-row">
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">姓名<span style="color: red">*</span></label>
                <div class="layui-input-inline">
                    <input type="text" id="relativesName" name="relativesName" lay-verify="required"  value="${greenTreatment.relativesName}"  class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">性别<span style="color: red">*</span></label>
                <div class="layui-input-inline">
                    <layui:simpleDictSelect style='layui-input-inline' type="gender"
                                            id="relativesSex" name="relativesSex"
                                            layVerify="required" lay-filter="relativesSex" value="${greenTreatment.relativesSex}"/>
                </div>
            </div>
        </div>
    </div>
    <div class="layui-row">
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">工作单位<span style="color: red">*</span></label>
                <div class="layui-input-inline">
                    <input type="text" id="relativesWork" name="relativesWork" lay-verify="required"  value="${greenTreatment.relativesWork}"  class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">联系电话<span style="color: red">*</span></label>
                <div class="layui-input-inline">
                    <input type="text" id="relativesIphone" name="relativesIphone" lay-verify="required" value="${greenTreatment.relativesIphone}"  class="layui-input">
                </div>
            </div>
        </div>
    </div>
    <div class="layui-row">
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">国籍<span style="color: red">*</span></label>
                <div class="layui-input-inline">
                    <input type="text" id="relativesNationality" name="relativesNationality" lay-verify="required" value="${greenTreatment.relativesNationality}"  class="layui-input">
                </div>
            </div>
            <div class="layui-inline">
                <label class="layui-form-label">身份证号<span style="color: red">*</span></label>
                <div class="layui-input-inline">
                    <input type="text" id="relativesIdCard" name="relativesIdCard" lay-verify="required" value="${greenTreatment.relativesIdCard}"  class="layui-input" >
                </div>
            </div>
        </div>
    </div>
    <div class="layui-row">
        <div class="layui-form-item">
            <div class="layui-inline">
                <label class="layui-form-label">特殊情况说明(最多100汉字)</label>
                <div class="layui-input-inline">
                    <textarea id="specialInstructions" name="specialInstructions"   class="layui-textarea" style="width: 740px" maxlength="200">${greenTreatment.specialInstructions}</textarea>
                </div>
            </div>
        </div>
    </div>
</fieldset>
<input type="hidden"  name="userId" value="${greenTreatment.userId}">
<input type="hidden"  name="companyId" value="${greenTreatment.companyId}">
<input type="hidden"  name="businessState" value="${greenTreatment.businessState}">
<input type="hidden"  name="businessStateCode" value="${greenTreatment.businessStateCode}" >
<input type="hidden"  name="processUserName" value="${greenTreatment.processUserName}">
<input type="hidden"  name="processUserId" value="${greenTreatment.processUserId}">
<input type="hidden"  name="handlingSuggestion" value="">
<input type="hidden"  name="processResult" value="${greenTreatment.processResult}">
<input type="hidden"  name="year" value="${greenTreatment.year}" >
<input type="hidden" name="roleName" value=${greenTreatment.roleName} />
<!-- 业务对象须有hidden字段，保存delFlag和version字段-->
<input type="hidden" name="delFlag" value=${greenTreatment.delFlag} />
<input type="hidden" name="id" value=${greenTreatment.id} />
